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Clinical efficacy of endovascular revascularization combined with vacuum-assisted closure for the treatment of diabetic foot

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World Journal of Diabetes 2024年第7期15卷 1499-1508页

作者： Feng-Rui Lei Xiao-Fei Shen Chuang Zhang Xin-Qing Li Hao Zhuang Hong-Fei Sang Department of Vascular Surgery The Second Affiliated Hospital of Soochow UniversitySuzhou 215004Jiangsu ProvinceChina

BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation *** most diabetic foot trauma is complicated by lower extremity arteriopathy,which becomes an independent risk factor for major amputation in diabetic foot *** To establish the efficacy and safety of endovascular revascularization(ER)combined with vacuum-assisted closure(VAC)for the treatment of diabetic *** Clinical data were collected from 40 patients with diabetic foot admitted to the Second Affiliated Hospital of Soochow University from April 2018 to April *** foot lesions were graded according to Wagner’s classification,and blood flow to the lower extremity was evaluated using the ankle-brachial index test and computerized tomography angiography of the lower extremity *** subcutaneous insulin infusion pumps were used to achieve glycemic *** limb revascularization was facilitated by percutaneous transluminal balloon angioplasty(BA)or *** were cleaned by nibbling *** granulation tissue growth was induced by VAC,and wound repair was performed by skin grafting or skin flap *** Of the 35 cases treated with lower limb revascularization,34 were successful with a revascularization success rate of 97%.Of these,6 cases underwent stenting after BA of the superficial femoral artery,and 1 received popliteal artery stent *** the 25 cases treated with infrapopliteal artery revascularization,39 arteries were reconstructed,7 of which were treated by drug-coated BA and the remaining 32 with plain old *** was performed in 32 ***-four cases of skin grafting and 2 cases of skin flap transplantation were *** patients underwent major amputations,whereas 17 had minor amputations,accounting for a success limb salvage rate of 95%.CONCLUSION ER in

关键词： Diabetic foot Revascularization vacuum-assisted closure Balloon angioplasty Wound repair

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Consensus on the application of negative pressure wound therapy of diabetic foot wounds

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Burns & Trauma 2021年第1期9卷 421-432页

作者： Shizhao Ji Xiaobin Liu Jie Huang Junmin Bao Zhaohong Chen Chunmao Han Daifeng Hao Jingsong Hong Dahai Hu Yufeng Jiang Shang Ju Hongye Li Zongyu Li Guangping Liang Yan Liu Gaoxing Luo Guozhong Lv Xingwu Ran Zhongmin Shi Juyu Tang Aiping Wang Guangyi Wang Jiangning Wang Xin Wang Bing Wen Jun Wu Hailin Xu Maojin Xu Xiaofei Ye Liangxi Yuan Yi Zhang Shichu Xiao Zhaofan Xia Burn Institute of PLA Department of BurnsThe First Affiliated Hospital of Naval Medical UniversityNo.168 Changhai RoadYangpu DistrictShanghai200433China Fujian Burn Institute Fujian Medical University Union HospitalNo.29 Xinquan RoadGulou DistrictFuzhou350001China Department of Burns&Wound Care Center Second Affiliated Hospital of Zhejiang UniversityCollege of MedicineNo.88 Jiefang RoadShangcheng DistrictHangzhou310009China No.3 Department of Burns and Plastic Surgery and Wound Healing Center The Fourth Medical Center of Chinese PLA General HospitalNo 51 Fucheng RoadHaidian DistrictBeijing100048China Foot and Ankle Surgery Department Guangzhou Zhenggu Orthopedic HospitalNo.449 Dongfeng Middle RoadYuexiu DistrictGuangzhou510031China Department of Burns and Cutaneous Surgery The First Affiliated Hospital of Air Force Medical UniversityNo.127 West Changle RoadXincheng DistrictXi’an710032China Wound Healing Department PLA Strategic Support Force Characteristic Medical CenterNo.9 Anxiang North LaneChaoyang DistrictBeijing100101China Department of Peripheral Vascular Beijing University of Chinese MedicineDongzhimen HospitalHai Yun Cang on the 5thDongcheng DistrictBeijing100700China Department of Orthopedics Zhejiang University School of MedicineSir Run Run Shaw HospitalNo.3 East Qinchun RoadShangcheng DistrictHangzhou310016China Department of Burns The Fifth Hospital of HarbinNo.27 Jiankang RoadXiangfang District150030HarbinChina Institute of Burn Research State Key Laboratory of TraumaBurn and Combined InjurySouthwest HospitalThird Military Medical UniversityGaotanyan Street no.29Shapingba DistrictChongqing400038China Department of Burn Shanghai Jiaotong UniversitySchool of Medicine Affiliated Ruijin HospitalNo.197 Ruijin Road(No.2)Huangpu DistrictShanghai200025China Department of Burn Surgery the Third People’s Hospital of WuxiNo.585 North Xingyuan RoadWuxi214043China Innovation Center for Wound Rpair Diabetic Foot Care CenterDepartment of Endoc

Because China is becoming an aging society,the incidence of diabetes and diabetic foot have been *** foot has become one of the main health-related killers due to its high disability and mortality *** pressure wound therapy(NPWT)is one of the most effective techniques for the treatment of diabetic foot wounds and great progress,both in terms of research and its clinical application,has been made in the last 20 years of its ***,due to the complex pathogenesis and management of diabetic foot,irregular application of NPWT often leads to complications,such as infection,bleeding and necrosis,that seriously affect its treatment *** 2020,under the leadership of Burns,Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association,the writing group for‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’was established with the participation of scholars from the specialized areas of burns,endocrinology,vascular surgery,orthopedics and wound *** on evidence-based practice suggested by the latest clinical research,this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic *** consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.

关键词： vacuum sealing drainage vacuum-assisted closure vacuum-assisted therapy Negative pressure wound therapy Topical negative pressure therapy Suction wound closure therapy Diabetic foot Diabetic ulcer Diabetic wound

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Effectiveness of negative pressure wound therapy in complex surgical treatment of necrotizing fasciitis of the upper limb

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World Journal of Orthopedics 2024年第11期15卷 1015-1022页

作者： Konstantin V Lipatov Arthur Asatryan George Melkonyan Aleksandr D Kazantcev Ekaterina I Solov’eva Denis V Krivikhin Irina V Gorbacheva Urii E Cherkasov Department of General Surgery Institute of Clinical Medicine named after N.V.SklifosovskySechenov First Moscow State Medical University(Sechenov University)Moscow 119021Russia Department of General Surgery Wound and Wound Infection SurgeryState Budgetary Institution“City Clinical Hospital named after S.S.Yudin of Moscow Healthcare Department”Moscow 115446Russia Department of General Surgery Physician of The Hospital for War Veterans No 3Moscow 129336Russia Department of General Surgery I.M.Sechenov First Moscow State Medical UniversityMoscow 119048Russia

BACKGROUND Necrotizing fasciitis(NF)of the upper extremities is a severe surgical pathology,and the incidence of this disease has been steadily increasing in recent *** treatment is accompanied by the formation of extensive wounds,which can be treated with significant *** recent years,negative pressure wound therapy(NPWT)has proven to be highly *** is also promising for the treatment of *** To explore the effectiveness of NPWT in the treatment of NF of the upper *** The results of the treatment of 36 patients with NF of the upper extremities in two groups(NPWT group and control group;2022−2023)were retrospectively *** the NPWT group,the NPWT method(120 mmHg;constant mode)was used after surgical *** number of vacuum-assisted dressings in patients ranged from 1 to 3,depending on the dynamics of the wound *** duration of fixation of one bandage was up to 2−3 *** the control group,conventional methods of local wound treatment were *** following indicators were analyzed:The treatment delay,the prevalence of inflammation,the microbial landscape,the number of debridements,the duration of wound preparation for surgical closure,and the nature of skin plastic *** Most patients experienced a significant treatment delay[4 d,interquartile range(IQR):2–7 d],which led to the spread of the pathological process to the forearm and *** most common pathogens were Staphylococcus aureus(14;38.9%)and Streptococcus pyogenes(22;61.1%).The average number of debridements per patient was 5(IQR:3–7),with no difference between *** average time to prepare wounds for surgical closure was 11±4 d in the NPWT group and 29±10 d(P=0.00001)in the control *** the NPWT group,the wounds were more often closed with local tissues(15;83.3%),and in the control group,split-thickness skin grafts were more often used(4;50%).CONCLUSION The predominant isolation of Staphylococcus aureus and/or Strep

关键词： Necrotizing fasciitis Upper limb Negative pressure wound therapy vacuum-assisted closure Surgical treatment

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Deep Sternal Wound Infections after Coronary Artery Bypass Grafting: Analysis of 29 Cases from Iraq

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World Journal of Cardiovascular Surgery 2022年第7期12卷 153-172页

作者： Raghda Basil Ismael Alkhateeb Asmaa Saleem Esmail Ah-Ghurabi Laith Saleh Alkaaby Abdulsalam Y. Taha Department of Cardiac Surgery Slemani Cardiac Hospital Sulaymaniyah Iraq The Diabetes Center in Sulaymaniyah Sulaymaniyah Iraq Department of Cardiac Surgery Iraqi Center for Heart Diseases Baghdad Iraq Department of Thoracic and Cardiovascular Surgery College of Medicine University of Sulaimani Sulaymaniyah Iraq

Background: Deep sternal wound infection (DSWI), or mediastinitis, is a devastating complication of coronary artery bypass grafting (CABG). This prospective study aimed to assess our management of DSWI in view of the published literature. Methods: Over 2-years (ending in January 2016), 29 patients (20 males) developed DSWI amongst 520 patients who underwent standard CABG surgeries (5.6%). Pre-, intra- and postoperative variables were documented. Whenever possible, the infections were culture-verified. Besides antibiotics, patients received one or more of the following therapies: drainage, debridement, closed irrigation, sternal re-wiring, vacuum-assisted closure (VAC), and bone resection. Results: the male to female ratio was 2.2:1. Mean age was 58.1 ± 7.3 years. The mean body mass index (BMI) was 27.9 ± 3.4 kg/m2. There were 18, 16 and 11 patients with diabetes mellitus (DM), hypertension and chronic obstructive pulmonary disease (COPD) respectively. Cardiopulmonary bypass (CPB) was utilized in 26 (89.7%) patients with a mean time of 117.5 ± 23.3 minutes. Most surgeries (n = 21, 72.4%) lasted 5 - 6 hrs. According to Pairolero classification, there were 3 (10.3%) Type I, 22 (75.9%) Type II and 4 (13.8%) Type III infections. Four (13.8%) cases were culture-verified. Twenty-three (79.3%) DSWIs were surgically managed. Sternal re-wiring was performed in 14 (48.3%) cases while VAC was added to other therapies in 2 (6.9%) patients. DSWIs completely resolved in 18 (62.0%) patients within 3 - 24 weeks while two (6.9%) patients died within 30 days. Conclusion: We have identified six independent risk factors for DSWI (male gender, obesity, DM, hypertension, COPD and CPB), five of them are modifiable.

关键词： Deep Sternal Wound Infection Mediastinitis Coronary Artery Bypass Grafting Median Sternotomy vacuum-assisted closure Wound Debridement

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比较负压封闭引流（VAC）与生物敷料A对创面修复的影响

比较负压封闭引流（VAC）与生物敷料A对创面修复的影响

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作者：崔泽龙广西医科大学

学位级别：硕士

目的探讨负压封闭引流与生物敷料A对创面修复的影响。方法对广西医科大学第四附属医院烧伤整形科自2007年9月至2009年2月收治的77例软组织损伤患者按照入院日期进行随机分组,单日入院者入研究组,共40例,双日入院者入对照组,共37例。研... 详细信息

目的探讨负压封闭引流与生物敷料A对创面修复的影响。方法对广西医科大学第四附属医院烧伤整形科自2007年9月至2009年2月收治的77例软组织损伤患者按照入院日期进行随机分组,单日入院者入研究组,共40例,双日入院者入对照组,共37例。研究组采用负压封闭引流结合二期刃厚皮片移植术治疗,对照组采用生物敷料A结合二期刃厚皮片移植术治疗,其中研究组和对照组分别有10例和8例患者未按既定方案完成治疗,故两组最终分别有30例和29完成治疗,进入结果分析。结果研究组30例患者通过治疗,8例治愈,13例显效,6例好转,3例无效,总有效率为90%,创面平均愈合时间为:17.1天;对照组29例患者通过治疗,3例治愈,10例显效,8例好转,8例无效,总有效率为:72%,创面平均愈合时间为:24.2天。两组疗效及创面平均愈合时间差异均有统计学意义。(P<0.05)。结论负压封闭引流技术为临床创面修复提供了一种新的思路和手段,值得推广应用。

关键词：负压封闭引流创面修复 VAC vacuum-assisted closure NPWT VSD

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